Apr 9, 20174 min read

Following Directions in Speech Therapy

Updated: Oct 30, 2020

The ability to follow directions is often worked on in speech therapy. Children are asked to follow directions in their everyday lives. In order to follow directions, the child requires a strong knowledge of basic concepts and the ability to process and retain auditory information.

From the time they are babies, we give children clues when we speak such as pointing, looking at an object and gesturing to help them to understand . Children learn a lot of vocabulary this way.

However, if we are trying to ascertain whether or not a child understands certain vocabulary or concepts, we need to be really careful not to give them any clues so that we know they are understanding the words we are saying. We also need to note the number of information carrying words.

What Is An Information-Carrying Word?

The concept of ”Information Carrying Words’ is one that is used frequently by Speech and Language Therapists in the UK but less commonly used in the US and Australia. The term was originally used by Knowles and Masidlover (1978) and forms the basis for the Derbyshire Language Scheme, an intervention programme for children with delayed language development.

The number of information carrying words in a sentence is not the total number of words but rather the number of words in the sentence that a child needs to understand in order to follow an instruction.

0 information-carrying words

An example of a sentence with 0 information carrying words would be if a parent held up their child’s coat and said “Put on your coat”. The child could tell from the context what they are being asked to do and would not be required to understand the word ‘coat’.

For a word to be an information-carrying word, there therefore must be an alternative choice and there must not be any clues from context such as gesture, looking at the object or copying what others are doing.

1 information-carrying word

The child only needs to understand the colour

The sentence “Which one is pink?” has four words but only one information-carrying word. The words “which one is” become redundant and the child only needs to understand the word “pink” to carry out the instruction.

In order to check that the child understands the word “pink” an alternative choice must be given e.g a choice of a blue sock and a pink sock as pictured above.

2 information-carrying words

The child needs to understand the colour and the object

‘Touch the blue mug’ has 2 information-carrying words if there is the choice of 2 mugs of different colours and another object in 2 different colours.

The child now has to understand the word ‘mug’ and the word ‘blue’ in order to correctly follow the instruction.

3 information-carrying words

The child needs to understand the size, the colour and the object.

‘Touch the small pink mug’ is a 3 information-carrying word sentence if there is the choice of mugs and another object of different colours and sizes. The child has to understand the word ‘small,’ the word ‘pink’ and the word ‘mug’ in order to correctly follow the instruction.

How many information-carrying words should a child understand?

As a child’s language develops, they are able to understand more information in a sentence or instruction. The number of information-carrying words that a child can understand is a good indicator of what stage they are at in their language development.

You can work on following commands of varying information-carrying word/keyword length by using real objects or pictures on a table or within the format of a game. Using objects can be time-consuming as you need to arrange the objects on the table, ensuring you have a choice of objects and concepts (e.g. different sizes, colours) for each instruction that you give. You also need to spend time tallying which can take away from the task.

This is where an app can be of huge benefit as it allows for a wide variety of instructions and automatic tallying of results. It is also very fun and motivating for the child. The Keyword Understanding app gives alternative choices at each graded level to check understanding of information-carrying words.

Comprehension Check

As Keyword Understanding uses a variety of objects, and the concepts of size (small, big) and colours (red, yellow, green, blue, pink), it is important to first check the child’s understanding of these items at the 1 information carrying-word level, before proceeding to a higher information-carrying word level. You can do this in the Comprehension Check component of the app. At higher information-carrying word levels, there is an increased auditory processing and memory load.

Object Size & Colour - Information-Carrying Words

Keyword Understanding includes graded tasks of increasing difficulty (2-6 information carrying words). These can be spoken instructions only, written instructions only or both.

An example following directions activity in the Keyword Understanding app — Following directions in speech therapy

Examples:

2 Keyword Level: Touch the pink bag
3 Keyword Level: Touch the small pink glasses
4 Keyword Level: Touch the green bucket and the yellow book
6 Keyword Level: Touch the small green phone and the big red glasses

Before & After - Temporal Directions

Keyword Understanding also includes Temporal Directions tasks which target the child ability to follow directions which include the words before/after at the start and/or in the middle of the sentence.

A temporal directions (before/after) activity in the Keyword Understanding speech therapy app. — Temporal directions in speech therapy